BMJ 2014;348:g2077 doi: 10.1136/bmj.g2077 (Published 19 March 2014)
Page 1 of 1
Letters
LETTERS ACCESS TO MORPHINE IN INDIA
Improving use of opioid analgesics in India Ashish K Kakkar clinical pharmacologist Department of Pharmacology, All India Institute of Medical Sciences, Bhopal – 462024, India
Amendments to the Narcotic Drugs and Psychotropic Substances (NDPS) Act are expected to improve access to drugs for millions of people in India who have chronic pain caused by cancer and other debilitating conditions.1 Since it came into force in 1985, there has been much criticism of the act, which aims to control drug misuse but leaves patients with cancer without access to opioids for managing pain. Although morphine isavailable on prescription at major cancer hospitals in India, most patients are denied access because doctors worry that patients may become addicted and the legal paperwork needed to acquire morphine is complex.
India has been the leading licit producer of opium to the world for decades, accounting for more than 90% of global production, even though its citizens are being denied opioids for terminal illnesses.2 The amendments are expected to change this scenario, and they have been welcomed by patients and prescribers alike. Overcoming regulatory barriers is only a part of the solution, however, and much needs to be done to improve the current
state of affairs. The Medical Council of India introduced palliative care as a postgraduate specialty in 2011, but the course is offered at one centre only with an annual intake of two students.3 Educating medical practitioners and helping them gain expertise in the use of morphine for chronic pain management should be an important goal. The irrational fears of health professionals, patients, and families over potential addiction to opioids also need to be eliminated. Competing interests: None declared. 1 2 3
Kmietowicz Z. Indian parliament votes to increase access to morphine. BMJ 2014;348:g1744. (24 February.) United Nations International Narcotics Control Board. Narcotic drugs: estimated world requirements for 2013—-statistics for 2011. 2013. www.incb.org/documents/NarcoticDrugs/Technical-Publications/2012/Narcotic_Drugs_Report_2012.pdf. Medical Council of India. Search colleges and courses. 2014. www.mciindia.org/ InformationDesk/CollegesCoursesSearch.aspx.
Cite this as: BMJ 2014;348:g2077 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Letters
LETTERS ACCESS TO MORPHINE IN INDIA
Improving use of opioid analgesics in India Ashish K Kakkar clinical pharmacologist Department of Pharmacology, All India Institute of Medical Sciences, Bhopal – 462024, India
Amendments to the Narcotic Drugs and Psychotropic Substances (NDPS) Act are expected to improve access to drugs for millions of people in India who have chronic pain caused by cancer and other debilitating conditions.1 Since it came into force in 1985, there has been much criticism of the act, which aims to control drug misuse but leaves patients with cancer without access to opioids for managing pain. Although morphine isavailable on prescription at major cancer hospitals in India, most patients are denied access because doctors worry that patients may become addicted and the legal paperwork needed to acquire morphine is complex.
India has been the leading licit producer of opium to the world for decades, accounting for more than 90% of global production, even though its citizens are being denied opioids for terminal illnesses.2 The amendments are expected to change this scenario, and they have been welcomed by patients and prescribers alike. Overcoming regulatory barriers is only a part of the solution, however, and much needs to be done to improve the current
state of affairs. The Medical Council of India introduced palliative care as a postgraduate specialty in 2011, but the course is offered at one centre only with an annual intake of two students.3 Educating medical practitioners and helping them gain expertise in the use of morphine for chronic pain management should be an important goal. The irrational fears of health professionals, patients, and families over potential addiction to opioids also need to be eliminated. Competing interests: None declared. 1 2 3
Kmietowicz Z. Indian parliament votes to increase access to morphine. BMJ 2014;348:g1744. (24 February.) United Nations International Narcotics Control Board. Narcotic drugs: estimated world requirements for 2013—-statistics for 2011. 2013. www.incb.org/documents/NarcoticDrugs/Technical-Publications/2012/Narcotic_Drugs_Report_2012.pdf. Medical Council of India. Search colleges and courses. 2014. www.mciindia.org/ InformationDesk/CollegesCoursesSearch.aspx.
Cite this as: BMJ 2014;348:g2077 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
